Der Unfallchirurg
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The journal Der Unfallchirurg and the German Society for Trauma Surgery (DGU) are connected by a colorful story, which reaches a climax in a mutual anniversary year in 2022. Der Unfallchirurg, initially named the Monthly Journal for Trauma Medicine (Monatsschrift für Unfallheilkunde) had already endured 125 years as the specialist journal of the DGU in 2019; however, in 1944 in the 51st year the publication came to a halt due to the upheaval and serious consequences of the Second World War and only reappeared in 1949 with the 52nd year. In its 100-year history the DGU passed through 4 temporally definable phases with respect to content, politics and personnel, to which must be added its preliminary phase as the Division of Trauma Medicine (Abtheilung für Unfallheilkunde) within the Society of German Natural Scientists and Physicians (GDNÄ). In the synopsis on the history of the specialist journal, this article analyzes the more than 125-year development of the DGU.
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With rising numbers of revisions of total arthroplasty procedures of the lower extremities, the annual number of cases of implant-associated infection are also increasing. The conventional two-stage replacement strategy often leads to increased morbidity and mortality of patients; however, in the literature a one-stage exchange procedure shows equally good results if the indications are strictly defined. ⋯ Despite existing controversies in the literature, this treatment approach seems to demonstrate a reduced hospitalization, reduced costs and improved patient satisfaction with the same re-revision rate. This review article explains the strategic approach to chronic infections of endoprostheses of the lower extremities based on clinical examples and a review of the current literature.
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Spondylodiscitis and postoperative wound infections are the most frequent infectious diseases of the thoracic and lumbar spine. Every spinal surgeon will come into contact with such patients during his or her career. Knowledge particularly of the diagnostics, conservative and surgical treatment as well as microbiological considerations of antibiotic treatment are therefore of particular importance and are explained in this article.
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Due to its low invasive nature, arthroscopy nowadays represents the gold standard in the treatment of native joint empyema. This article gives a summary of the literature with expert recommendations, reviews and case reports on arthroscopic treatment of native joint empyema and the limitations. ⋯ In postoperative infections with enclosed foreign material, such as after cruciate ligament reconstruction, the foreign material can in most cases be left in and successful infection eradication can be carried out with several arthroscopic lavages and débridement. In cases of higher grade infections with destruction of the joint, arthroscopic treatment alone is normally insufficient.
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[Vascular diagnostics before microvascular tissue transfer on the lower extremities : An algorithm].
Microsurgical free flap transfer plays a key role in soft tissue reconstruction of the lower extremities. Through close cooperation between plastic and orthopedic surgery, great progress and success in limb salvage could be achieved over the last decades. The risk for extremity malperfusion is especially high in older patients and after trauma. ⋯ In the case of intraluminal stenosis without any option for PTA, a vascular surgeon can be involved at an early stage to evaluate further surgical options. In some cases, similar surgical revascularization and free flap transfer can be performed in a single surgery. The aim of this study is to implement a standardized algorithm for preoperative examination and radiological diagnostics before reconstructive surgery of the lower extremity.